HEALTHCARE-ASSOCIATED VIRAL INFECTIONS IN HOSPITALIZED CHILDREN AT THE KAROLINSKA UNIVERSITY HOSPITAL

Abstract Background Healthcare-associated viral infections (HA-VI) are common in hospitalized children and are increasingly recognized as a cause of preventable harm. Yet, epidemiology and modifiable risk factors related to pediatric HA-VI are currently poorly understood. Methods We performed a prospective case–control study to identify the risk factors and outcomes associated with pediatric HA-VI at a quaternary care children’s hospital between November 2016 and August 2018. Prospective surveillance for HA-VI was performed hospital-wide by certified infection preventionists using NHSN definitions. Cases were matched 1:1 to controls by age, duration of hospitalization, and hospital unit. We abstracted data from the electronic medical record and conducted semi-structured interviews with patient caregivers to identify potential exposures beginning 4 days prior to HA-VI identification date. We also measured length of antibacterial therapy (LOT) in the 7 days following enrollment. Results During the study period, we identified 143 eligible patients with HA-VI and enrolled 64 matched case–control pairs. In total, 79 viruses were identified among 64 case patients, of which 53 (67.1%) were respiratory viruses and 26 (32.9%) were GI. Case patients were more frequently exposed to a sick visitor, specifically either caregiver or sibling, compared with controls (18.8% vs. 9.4%; P = 0.20, Fisher exact test). During the exposure period, case patients also had a significantly higher number of hospital procedures performed when compared with controls (n = 320 vs. 232; X2 = 58.43, P < 0.001). Case, when compared with control, patients had a greater average LOT (2.89 vs. 1.08). Conclusion Results of study show that exposure to a sick visitor is a potentially modifiable risk factor for pediatric HA-VI. In addition, hospitalized children with HA-VI have increased exposure to antibacterial antibiotics when compared with matched controls. Prevention of pediatric HA-VI may have implications for antibiotic stewardship. Our findings suggest that hospital policies may need to be revised, with emphasis on visitor screening and partnership with families, to reduce the incidence of pediatric HA-VI during hospitalization. Disclosures All authors: No reported disclosures.

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The evolving epidemiology of acute gastroenteritis in hospitalized children in Italy

European Journal of Pediatrics ◽

10.1007/s00431-021-04210-z ◽

2021 ◽

Author(s):

Brigida Stanyevic ◽

Margherita Sepich ◽

Samanta Biondi ◽

Giampiero Igli Baroncelli ◽

Diego Peroni ◽

...

Keyword(s):

Acute Gastroenteritis ◽

Viral Infections ◽

Selection Process ◽

University Hospital ◽

Hospitalized Children ◽

Rotavirus Vaccines ◽

Number Of Patients ◽

Causative Agents ◽

Few Data ◽

Rotavirus Infections

AbstractFew data are available on the prevalence and features of acute gastroenteritis (AGE) in hospitalized children in Italy, where specific rotavirus vaccines were introduced into the national vaccination plan in 2017. To evaluate vaccination effects on AGE epidemiology, we analysed data from children aged ≤ 18 years admitted for AGE at the University Hospital of Pisa in 2019, comparing them with those recorded in 2012. Demographical, clinical, diagnostic, and treatment data were collected reviewing medical records and were therefore compared. In 2019 and 2012, 86 (median age 2.5 years [IQR 1.4–5.9]) and 85 children (median age 2.3 years [IQR 1.3–5.1]) were respectively admitted with AGE. The most common symptoms were diarrhoea and vomiting; decreased skin turgor was more frequent in 2019 (54% and 34% respectively, p = 0.01). Viral infections were more common than bacterial ones; in 2019, a decrease in rotavirus infections (67% and 22%, p = 0.003) and an increase in adenovirus infections (50% and 10%, p = 0.002) and in the number of patients with negative stool testing (58% and 39%, p = 0.04) were found.Conclusions: Viral infections are the leading cause of AGE in hospitalized children in Italy. The introduction of rotavirus vaccines did not reduce the number of hospitalizations per year. Adenovirus and other non-routinely screened viruses may be undergoing a selection process making them common causative agents for AGE. What is Known:• Rotavirus is the leading cause of acute severe gastroenteritis in children worldwide, especially < 5 years of age.• The introduction of specific vaccines may be changing its epidemiology.• Few data are available on acute gastroenteritis in hospitalized children in Italy. What is New:• Viral infections are the leading cause of acute gastroenteritis in hospitalized children in Italy.• Specific vaccines are reducing rotavirus infections, but adenovirus and other non-routinely screened viruses may be undergoing a selection process making them common causative agents for gastroenteritis.

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Burden of healthcare-associated infections among hospitalized children within community hospitals participating in an infection control network

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.67 ◽

2021 ◽

pp. 1-3

Author(s):

Ibukunoluwa C. Akinboyo ◽

Rebecca R. Young ◽

Michael J. Smith ◽

Sarah S. Lewis ◽

Becky A. Smith ◽

...

Keyword(s):

Infection Control ◽

Bloodstream Infections ◽

Central Line ◽

Control Network ◽

Hospitalized Children ◽

Healthcare Associated Infections ◽

Community Hospitals ◽

Prospective Surveillance ◽

Healthcare Associated ◽

Pediatric Healthcare

Abstract We describe the frequency of pediatric healthcare-associated infections (HAIs) identified through prospective surveillance in community hospitals participating in an infection control network. Over a 6-year period, 84 HAIs were identified. Of these 51 (61%) were pediatric central-line–associated bloodstream infections, and they often occurred in children <1 year of age.

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Influenza Viral Infections Surveillance and Clinical Presentations in Hospitalized Children: A Cross-Sectional Study

Current Respiratory Medicine Reviews ◽

10.2174/1573398x17666210319094524 ◽

2021 ◽

Vol 17 ◽

Author(s):

Montaha Al-Iede ◽

Lena Sarhan ◽

Leen Abushanab ◽

Tamara Ayasrah ◽

Rafaa Al Maani ◽

...

Keyword(s):

Respiratory Infections ◽

Respiratory Viruses ◽

Influenza Viruses ◽

University Hospital ◽

Severe Illness ◽

Influenza B Virus ◽

Influenza B ◽

Hospitalized Children ◽

Acute Respiratory Infections ◽

Clinical Presentations

Background: Influenza virus and other respiratory viruses have been identified as an essential cause of acute respiratory infections (ARIs) in children worldwide. However, there are few data on its frequency and clinical presentation in Jordan. Objectives: We aimed to identify the viral etiology of acute respiratory infections and the various clinical presentations in hospitalized children, especially those with influenza viruses compared to other respiratory viruses. Methods: A retrospective study that was conducted at the Jordan university hospital. All the positive nasopharyngeal aspirates that were collected from hospitalized children aged 0-19 years from January 2017 to January 2019 were reviewed. Results: A total of 338 nasopharyngeal aspirates (NPAs) with positive viral serology results were reviewed. Among the patients younger than four years, the RSV virus was the most frequently detected. However, the Influenza B virus was the most commonly seen in patients older than 5 years, H1N1 was more frequent in autumn (29.5%), and RSV was the most frequent virus in winter. Bronchopneumonia was the most frequent diagnosis among all hospitalized patients, followed by bronchiolitis. Out of 338 patients, 50.3 % had tachypnea, 70.7% of patients were admitted to the pediatric floor, while 18.6% presented with a severe illness and required admission to the pediatric intensive care unit (PICU). Infants under the age of one were more likely to have higher co-infection rates with other viruses compared to children over five years that had influenza. Conclusion: Presentations of influenza and other respiratory viruses vary between different age groups, such as sepsis in children younger than one year.

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Clinical Epidemiological and Pathogenic Analyses for Acute Viral Infections of Central Nervous System in Hospitalized Children of Hunan Province, China

Clinical Microbiology Open Access ◽

10.4172/2327-5073.1000306 ◽

2018 ◽

Vol 07 (01) ◽

Author(s):

Bing Zhang ◽

Tian Yu ◽

Yi min Zhu ◽

Jie Xiong ◽

Sai zhen Zhen ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Viral Infections ◽

Hunan Province ◽

Hospitalized Children

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Viral coinfection in the oral cavity of HIV-infected children: relation among HIV viral load, CD4+T lymphocyte count and detection of EBV, CMV and HSV

Brazilian Oral Research ◽

10.1590/s1806-83242005000300013 ◽

2005 ◽

Vol 19 (3) ◽

pp. 228-234 ◽

Cited By ~ 10

Author(s):

Liliane Janete Grando ◽

Denise Cantarelli Machado ◽

Silvia Spitzer ◽

Sharon Nachman ◽

Fred Ferguson ◽

...

Keyword(s):

New York ◽

Viral Load ◽

Oral Cavity ◽

T Lymphocyte ◽

Lymphocyte Count ◽

Viral Infections ◽

University Hospital ◽

State University ◽

Hiv Viral Load ◽

Viral Coinfection

Viral coinfection in the oral cavity associated to HIV infection was evaluated in 180 children from birth to 13 years of age of both sexes. The oral examinations were performed at the Pediatric AIDS Outpatient Clinic, São Lucas Hospital and Clinic Hospital, both in Porto Alegre, Brazil and at the School of Dental Medicine, University Hospital Center, State University of New York at Stony Brook, USA. The aim of this study was to identify the presence of viral infections in the oral cavity. PCR technique was used to determine opportunistic viral infections caused by CMV, EBV, and HSV in mucosal swabs. A high frequency of viral infection was detected in the oral cavity of HIV-infected children determined by the PCR technique. HIV-infected children with viruses had a favorable CD4+T lymphocyte count and unfavorable viral load.

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Prospective surveillance of hospital associated infections epidemiology in a haematology-oncology department

International Journal of Infection Control ◽

10.3396/ijic.v15i1.002.19 ◽

2019 ◽

Vol 15 (1) ◽

Author(s):

Nabiha Bouafia ◽

Asma Ammar ◽

Olfa Ezzi ◽

Asma Ben Chiekh ◽

Mohamed Mahjoub ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Analyses ◽

University Hospital ◽

Prospective Surveillance ◽

Tertiary Teaching ◽

Tertiary Teaching Hospital ◽

Oncology Unit ◽

A Prospective Study ◽

Healthcare Associated ◽

Hospital Associated Infections

In haematology-oncology, intensified procedures have been associated with higher risk of healthcare associated infections (HAIs).This study aimed to estimate the incidence and to identify risk factors of HAIs in a haematology-oncology unit in a Tunisian university hospital. We conducted a prospective study, during 06 months from Mars through September 2016 in the department of hematology- oncology in a tertiary teaching hospital in Tunisia. Patients, admitted for ≥48 h, were followed until hospital discharge. The (CDC) criteria for site-specific infections were used to define HAIs. Bivariate and multivariate analyses were performed to identify risk factors of HAIs. P

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#87: Association Between Healthcare-Associated Respiratory Viral Infections and Length of Stay at a Pediatric Hospital

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piaa170.044 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

pp. S15-S15

Author(s):

Zachary Most ◽

Michael Sebert ◽

Patricia Jackson ◽

Trish M Perl

Keyword(s):

Length Of Stay ◽

Incubation Period ◽

Respiratory Infection ◽

Symptom Onset ◽

Viral Infections ◽

Pediatric Hospital ◽

Time Period ◽

Life Years ◽

Respiratory Viral Infections ◽

Healthcare Associated

Abstract Background Healthcare-associated infections (HAI) are major preventable causes of morbidity and mortality. While there are fewer overall HAI in children, there is a greater potential impact in disability-adjusted life years. Healthcare-associated respiratory viral infections (HARVI) are not frequently tracked within institutions, yet the risk for such infections in pediatric hospitals is very high. Recent data demonstrate large inter-hospital variability of HARVI incidence that may depend on various factors including the number of immunocompromised patients in the hospital and the presence of shared rooms. We hypothesize that the burden of healthcare-associated respiratory viral infections and their impact on the length of stay (LOS) is substantial at a large urban pediatric hospital. Methods A cohort of all children with any HARVI admitted to a large urban pediatric hospital between July 2017 and June 2018 were included after obtaining IRB approval. We defined a HARVI as a respiratory infection with an onset of symptoms while the patient was hospitalized meeting three criteria: A positive microbiologic test for one of 8 viruses, presence of symptoms of a respiratory infection, and onset of symptoms after admission beyond the minimum incubation period for each virus. Infections with symptom onset after admission beyond the maximum incubation period were considered definite hospital onset whereas others were considered possible hospital onset. The electronic medical record provided data on demographics, underlying medical conditions, hospital length of stay prior to infection and hospital unit of infection, and consequences and outcome of HARVI. The at-risk population for calculation of the incidence of HARVI was all admitted patient-days at the hospital over this time period. Results Between July 2017 and June 2018 the incidence of HARVI (definite or possible hospital onset) was 1.2 infections per 1,000 admitted patient-days (60% due to rhinovirus/enterovirus, 12% due to respiratory syncytial virus, and 9% due to influenza). Overall, 48% of patients were under 2 years of age, 18% were between 2 and 5 years of age, and 34% were over 5 years of age. Twenty-one percent were immunocompromised and 35% had underlying lung disease. The median length of stay prior to symptom onset was 11 days (IQR 5–36 days) and the median total length of stay was 30 days (IQR 15–82.5 days). Eight individuals had more than one HARVI over this time period. Nineteen percent were transferred to the intensive care unit and 7% died during their hospital admission Conclusion HARVI occurs frequently in a pediatric hospital and often in patients with underlying comorbidities. The risk for HARVI increases substantially with increased length of stay. Such data support the need for tracking HARVI in high-risk institutions.

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Point prevalence of healthcare-associated infections and antibiotic use in a tertiary care teaching hospital in Nepal: A cross-sectional study

Journal of Infection Prevention ◽

10.1177/17571774211035827 ◽

2021 ◽

pp. 175717742110358

Author(s):

Sailesh Kumar Shrestha ◽

Swarup Shrestha ◽

Sisham Ingnam

Keyword(s):

Prevention And Control ◽

Tertiary Care ◽

Antibiotic Use ◽

Point Prevalence ◽

University Hospital ◽

Infection Prevention And Control ◽

Healthcare Associated Infections ◽

Prevalence Survey ◽

Healthcare Associated ◽

And Control

Information on the burden of healthcare-associated infections (HAIs) and patterns of antibiotic use are prerequisites for infection prevention and control (IPC) and antibiotics stewardship programmes. However, a few studies have been reported from resource-limited settings and many of them have not used standard definitions to diagnose HAI precluding benchmarking with regional or international data. This study aims to estimate the prevalence of HAIs and antibiotic use in our centre. We conducted a point prevalence survey in a 350-bed university hospital in Kathmandu, Nepal in April 2019. We reviewed all patients aged ⩾ 18 years admitted to the hospital for at least two calendar days and evaluated for the three common HAIs—pneumonia, urinary tract infection and surgical site infection. We used the clinical criteria by the European Center for Disease Prevention and Control to diagnose the HAIs. We also collected information on the antibiotics used. Of 160 eligible patients, 18 (11.25%) had HAIs and 114 (87.5%) were on antibiotics, with more than half of them (61/114 patients, 53.5%) receiving two or more antibiotics. This highlights the need for effective implementation of IPC as well as antibiotics stewardship programmes in our centre.

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